Surgical Procedures, Operative Commons^™

The Promise Of Precision: Evaluating The Efficacy Of Robotic-Assisted Total Knee Arthroplasty, Jodi Wernikoff

SIU Journal of Medical Science Scholarly Works

Purpose: This article aims to review the treatment of patients diagnosed with primary knee osteoarthritis requiring a total knee arthroplasty and examine if the use of robotic- assisted surgery compared to traditional manual surgery results in improved functional outcomes and fewer post-operative complications.

Method: A PubMed literature search was conducted using the search terms total knee arthroplasty, robot surgical procedures, knee osteoarthritis, and quality of life. Nine articles were retrieved and served as the basis for this clinical review.

Results: While RA-TKA holds promise, more comprehensive comparative research is still required to assess the efficacy of RA-TKA in comparison to …

Double-Port Totally Endoscopic Mitral Valve Replacement Through A Prosthesis-Sized Working Incision With Posterior Subvalvular Preservation, Cao Dang Khang, Tran Duc Quang, Phan Quang Thuan, Vuong Ngoc Minh, Pham Tran Viet Chuong, Nguyen Hoang Dinh

Journal of the Saudi Heart Association

Objective: To evaluate the feasibility and early outcomes of totally endoscopic non-robotic mitral valve replacement using a double-port DCT approach with posterior subvalvular preservation.

Methods: In this single-center retrospective observational study, 76 consecutive patients underwent totally endoscopic non-robotic mitral valve replacement between November 2023 and December 2025. The DCT approach was defined by exclusive endoscopic visualization, no rib spreading, a camera port and prosthesis-sized working incision placed in the same intercostal space, and thoracoscopic intracardiac instrumentation. Posterior ventricular-annular continuity was preserved whenever feasible by posterior leaflet preservation, native chordal preservation, or artificial chordal reimplantation after leaflet resection. Outcomes were reported …

Isolated Giant Aneurysm Of The Acute Marginal Branch Of Right Coronaryartery Presenting As Nstemi: Successful Direct Surgical Repair Preserving The Native Flow, Sai Kumari Ms., Anbarasu Mohanraj Dr, Saranya Damodaran Ms

Journal Of Indian Physician Associates

Abstract

Background: A “giant” coronary artery aneurysm is variably defined in the literature—commonly as a dilatation of a coronary vessel exceeding four times the diameter of the adjacent normal segment, or exceeding a fixed threshold such as > 8 mm or > 20 mm in diameter^1.

Case presentation: We report the case of a 61-year-old woman with type II diabetes mellitus and systemic hypertension, who presented with breathlessness and chest pain radiating to the back. She had recently suffered a non-ST elevation myocardial infarction (NSTEMI) and was found on coronary angiography to have a large aneurysm of the acute marginal branch …

Safety And Feasibility Of Same-Admission Transcarotid Arterial Revascularization Prior To Heart Surgery For Patients Presenting With Concurrent, Severe Carotid Artery Stenosis, And Surgical Cardiac Disease, Brittany Landavazo, Matthew D. Kenny, Chandler Vernon, Nicolas Zea, David Nation, Bradley Boone, Jeff Apple, Kofi Quaye, Shir Yelovitch, Ryan S. Turley

HCA Healthcare Journal of Medicine

Introduction

Carotid artery stenosis and coronary artery disease are often co-morbid, with a prevalence of concurrent carotid and coronary artery stenosis approaching 50%. The optimal treatment for these patients has long been debated, with open carotid revascularization generally reserved for those with severe symptomatic carotid disease that precludes cardiac surgery. In this scenario, the role of less-invasive carotid artery stenting, particularly transcarotid arterial revascularization (TCAR), remains controversial and is not yet well studied. This study aims to present our outcomes and methodology for treating severe carotid stenosis with TCAR prior to cardiac surgery.

Methods

A retrospective chart review of the …

How Does Pattern Of Bone Healing Affect The Strain Of Plate Implant Via Frequency Detection? A Biomechanical Cadaveric Study, Chavarin Amarase, Chanyaphan Virulsri, Pairat Tangpornprasert, Pisitpong Chancharoen, Saran Tantavisut

Chulalongkorn Medical Journal

Background: Detecting bone union is a crucial process in treating bone fractures to prevent complications, including implant failure and bone nonunion. Nowadays, there are many methods and new innovative devices for detecting bone union through strain measurements, such as strain gauges, fluid level displacement, contrast media, and frequency changes. There is also a trend toward increasing these methods in the future. However, the patterns of bone healing studied with these methods still do not provide a standard for determining the true bone healing process. The aim of this study is to identify the most appropriate bone healing pattern for …

Utilizing Femoral Metaphyseal Sleeves In Primary Total Knee Arthroplasty For Post-Traumatic Osteoarthritis: A Case Report, Zachary Sukin, Adam Dentinger, Jeremiah Earl

HCA Healthcare Journal of Medicine

Background

Total knee arthroplasty in younger patients presents a heightened risk of postoperative complications and implant failures compared to older populations, particularly in those with posttraumatic arthritis. These challenges necessitate careful consideration and specialized approaches to optimize the outcomes in this patient demographic.

Case Presentation

A 43-year-old man presented with left knee pain resulting from a traumatic lawn mower injury, causing an intraarticular distal femur, at the age of 6. The injury led to a limb-length discrepancy for which he underwent 2 limb-lengthening procedures in his early 20s. Radiographs demonstrated advanced posttraumatic osteoarthritis, and the patient elected to proceed with …

Enhancing Cataract Surgery Outcomes: Optimal Use Of Pre- And Post-Operative Eye Drops, Keith Skolnick M.D., Anu Valiaveedu

Mako: NSU Undergraduate Student Journal

Many preoperative and postoperative cataract patients struggle with comprehending the use of prescription medication as directed. Language barriers and low health literacy levels are major factors contributing to improper use of prescriptions. To increase patients comprehension, the Fort Lauderdale Eye Institute employed an educational intervention consisting of a live presentation and an instructional video. Results found that 44% of patients were hesitant to ask questions to clinical staff, 32% felt overwhelmed, and nearly 70% lacked confidence in using their prescribed eye drops. Following the intervention, 91% of patients reported increased confidence in their medications, and most indicated that the video …

Can Implementation Strategies Diminish Infection Prevention Barriers And Reduce Cardiac Surgical Site Infections, Jennifer West, Jennifer Gutowski, Jarvis Mcgrath, Kristen Paliani, Emil P. Lesho

Advances in Clinical Medical Research and Healthcare Delivery

Background:

Surgical site infections (SSI) can affect up to 26.8% of patients undergoing coronary artery bypass grafting (CABG). In New York State (NYS), hospitals are evaluated by comparing their risk-adjusted CABG SSI rates to the NYS average rate. In 2021, our facility’s rate was significantly higher than the NYS average at 3.40 and 1.51, respectively. We sought to reduce infection rates using a multidisciplinary Implementation Science (IS) approach across the continuum of care.

Methods:

Standardized definitions from the National Healthcare Safety Network were utilized in a 24-month before and after study at a 528-bed hospital that averages 468 CABG/year. In …

5x-Multiplier Vs 3-Tier Model For Discharge Opioid Prescriptions After Intra-Abdominal Cancer Surgery: Randomized Clinical Trial Protocol, Brittany C. Fields, Timothy E. Newhook, Heather A. Lillemoe, Wei Qiao, Jose A. Karam, Surena F. Matin, Larissa A. Meyer, Ching-Wei D. Tzeng

Advances in Cancer Education and Quality Improvement

Background

Surgeons provide up to 10% of total opioid prescriptions across all specialties, and more than one-third of surgeon-prescribed medications are opioids. Patient-reported opioid consumption and risk of persistent opioid use beyond the postoperative recovery period correlate with the initial opioid quantity prescribed at discharge. Interventions to reduce postoperative opioid prescribing have demonstrated no adverse effects on pain control or increased need for prescription refill; however, in the absence of standardized prescription protocols, opioid prescribing practices vary widely.

Objective

The study objective is to identify the opioid prescribing model that provides the lowest oral morphine equivalents (OME) volume prescribed at …

From Molars To Bronchus; The Tale Of An Aspirated Dental Instrument, Yisroel Grabie, Sudeep Acharya, Fasih Sami Siddiqui, Gabriel A. Chavez Reyna, Michel Chalhoub

HCA Healthcare Journal of Medicine

Background

Aspiration of dental instruments is a rare event that carries potentially serious complications when it occurs, especially in older patients, where protective reflexes are diminished. Clinical management may be difficult because of the risk of granulation tissue and different retrieval strategies according to the object’s characteristics. In this report, we describe the case of an 84-year-old man who aspirated a dental bur during a routine dental procedure, necessitating immediate intervention. Timely and precise management was essential to avert severe complications.

Case Presentation

During a routine dental procedure, an 84-year-old man aspirated a bud-shaped cross-cut carbide dental bur. Despite initial …

External Jugular Vein Catheterization Technique For Continuous Blood Sampling In Gilts, Preechaphon Taechamaeteekul, Yosua Kristian Adi, Chutikan Srisang, Pirada Virankabutra, Natchanon Dumniem, Jinda Singlor, Padet Tummaruk

The Thai Journal of Veterinary Medicine

External jugular vein blood collection is common in gilts and sows, but continuous sampling for hormonal and pharmacokinetic research requires catheterization. The standard protocol has remained largely unchanged for nearly 40 years. This study aimed to develop a modified external jugular vein catheterization technique in gilts. Ten gilts (72.0 ± 3.4 kg) underwent surgery under general anesthesia after 12-hour fasting. Sedation was induced with intramuscular Xylazine (4.4 mg/kg) and Tiletamine–Zolazepam (2.2 mg/kg), followed by intravenous Thiopental sodium (10 mg/kg). Once anesthetized, gilts were placed in dorsal recumbency, and the external jugular fossa was prepared under sterile conditions. A 10 cm …

Atypical Presentation Of Non-Small Cell Lung Carcinoma With Metastasis To Breast Tissue, Tylar P. Seckman, Diane Krutzler-Berry, Mohamed Ashal, Waqas Mahmud, Krista L. Denning, Logan M. Lawrence

Marshall Journal of Medicine

Malignant neoplasms of the lung commonly metastasize to lymph nodes, bone, brain, and liver via hematogenous and lymphatic routes. Much less commonly, metastasis occurs in the breast. Secondary metastatic disease of the breast is very rare, with a reported incidence ranging from 0.4-1.3%­­—with primary lung cancer being one of the most anomalous sources. This case details non-small cell lung cancer metastasis to the breast with proven primary contralateral lung origination. This atypical finding prompts medical professionals to consider these malignant cells' immunologic, histologic, and pathologic makeup to understand further and treat the neoplasm.

Comprehensive Overview Of Gastroschisis, Alexis Carver

Mako: NSU Undergraduate Student Journal

Gastroschisis is a congenital defect of the abdominal wall viscera that occurs during early embryonic development, leading to the protrusion of bowel through an opening near the umbilical cord. This condition is classified as either simple, involving only the bowel, or complex, involving additional complications like necrosis or intestinal atresia. While the exact cause of gastroschisis remains unknown, it is believed to be influenced by a combination of genetic and environmental factors. This congenital disorder affects a very small percentage of neonates, and the associated mortality rates are relatively low due to modern developments in medical science. Gastroschisis can be …

Dobbs And Sterilization Decision-Making: Understanding The Coercive Spillover Effects In Reproductive Choice, Thomas Wilson Williams

Pace Law Review

The Supreme Court majority in Dobbs v. Jackson Women’s Health Organization argued their decision would have limited impact beyond abortion rights. This Article examines how Dobbs and subsequent state abortion restrictions are likely to increase women’s reliance on permanent sterilization procedures, particularly among already marginalized populations. Drawing on emerging data and historical context, I argue that some post-Dobbs sterilizations should be understood as effectively coerced by state policies, implicating reproductive justice concerns and potentially undermining fundamental rights established in Skinner v. Oklahoma. Then, I demonstrate how interdisciplinary bioethics frameworks and methodologies can help courts better understand the full …

Cataract Simulator Training And Medical Student Attitudes Towards Ophthalmology, Victor Sanchez, Christian Diaz, Zachary Elkin, Laura Palazzolo, Andrea Blitzer, Manjool Shah, Christina R. Prescott

Journal of Academic Ophthalmology

Introduction: Simulation-based learning offers novel opportunities to teach ophthalmology to medical students and inspire interest in the field. Eyesi surgical simulators have become widely adopted by ophthalmology departments and may serve a purpose in medical student education. The purpose of this study was to evaluate the effect of cataract simulators on medical student attitudes towards ophthalmology and to assess their performance/improvement on a series of simulator tasks.

Methods: This was a prospective, cross-sectional study of 31 medical students. Participants were recruited through an email sent via the school’s listserv. Enrolled students completed a series of tasks on the …

A Case Of Cecal Volvulus In The Setting Of Multiple Sclerosis, S. Jiaming Lin, Paige M. Kieper, Michael Mullinax, Jake W. Vogel, Kimberly Syres

Advances in Clinical Medical Research and Healthcare Delivery

This case report describes a patient with a history of multiple sclerosis (MS) and optic neuritis, who presented with acute onset of generalized abdominal pain. The patient was ultimately diagnosed with cecal volvulus requiring emergent laparotomy and right hemicolectomy. This case highlights the relationship between neurogenic bowel dysfunction (NBD) associated constipation in patients with MS and intestinal volvulus. Additionally, this case demonstrates the importance of NBD associated constipation management through various modalities including laxative regimens, behavioral and diet modification, and reduction of polypharmacy, with an emphasis on individualized patient management.

Same Or Different? Resolution Of Diagnostic Difficulty Of Two Mixed Cell-Type Tumors In Ovarian Pathology., Sarah Ingram, Priyanka Raju Md, Wei Shaw Do, Steve Sowers Pa, Kelly Brenan-Rothschild Md

Transformative Medicine

Introduction: When confronted by two disease processes, physicians in all disciplines are faced with the question: Are they manifestations of a common etiology, or distinct entities co-occurring? Inherent in this dilemma is whether an aberration from normal is even a disease process at all. Tissue pathology plays a key role in resolving this conundrum. Although diagnoses can be challenging, there are various methodologies used in the field of pathology to ascertain whether two tumors are of the same or different origins.

Case Description: This case report reviews two patients with large ovarian neoplasms and surgical pathology revealing histopathological features of …

Recent Studies In The Surgical Treatment Of Tetralogy Of Fallot, Emma C. Gardner

Mako: NSU Undergraduate Student Journal

No abstract provided.

Early Outcome Of Mini-Mvs Surger Y Elsherif Et Al., Mahmoud Abdullghany Amin Elsherif, Rasha Hosny, Mohamed Ramadan Mohamed

Journal of Medicine in Scientific Research

Background: The conventional incision adopted to for mitral valve replacement is the full sternotomy, with proved over time and experience to be a simple and safe method. Minimal invasive mitral valve surgery (Mini-MVS) is an alternative approach for elective mitral surgeries that proved over the last years to be a promising option.

Aim of the study: Assessment of the early outcome of minimally invasive mitral valve surgery with or without tricuspid surgery.

Methods: A retrospective study on 100 consecutive patients who underwent minimal invasive mitral valve surgery from January 2021 to June 2023 at National Heart Institute in Egypt.

Results: …

Slow Surgical Correction Affects More Than Just The Bowels, Emilia M. Clementi

Clinical Research in Practice: The Journal of Team Hippocrates

Reflection on how delayed colostomy reversal affects a patient's mental and physical well-being.

Successful Surgical Outcome After Traumatic Diaphragmatic Intra-Pericardial Herniation From Blunt Abdominal Injury, Tyler Bayliss, Mark H. Cooper, Paul Bown

Marshall Journal of Medicine

Intrapericardial diaphragmatic hernia (IPDH) is a rare manifestation of non-hiatal diaphragmatic hernias (NHDH). Intrapericardial diaphragmatic hernia is defined as the prolapse of the abdominal viscera into the pericardium through the diaphragm. Their incidence has increased over the last 50-60 years, secondary to high-speed transport, and constitutes 5% of major thoracic and abdominal trauma today. These injuries can present during the initial workup or months after the initiating injury. These hernias can be caused by both blunt and penetrating trauma with concomitant central tendon rupture and pericardial laceration. We report an interesting case of intrapericardial diaphragmatic hernia with delayed presentation that …

Early Closure Of Colostomy From Abdominal Trauma May Be Beneficial In Otherwise Healthy Patients, Nicole Xu

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising

Khalid MS, Moeen S, Khan AW, Arshad R, Khan AF. Same admission colostomy closure: a prospective, randomised study in selected patient groups. Surgeon. 2005;3(1):11-14. https://doi.org/10.1016/s1479-666x(05)80004-6

for a patient with loop transverse colostomy due to trauma

Chewed Versus Swallowed Ticagrelor In P2y12 Inhibitor-Naïve Patients Undergoing Percutaneous Coronary Intervention, Thomas F. Wilson, Muddasir Ashraf, M. Fuad Jan, Tonga Nfor, Louie Kostopoulos, Joaquin Solis, Jayant Khitha, Ahmad Khraisat, Anthony C. Defranco, Tanvir Bajwa, Suhail Q. Allaqaband

Journal of Patient-Centered Research and Reviews

Purpose: Dual antiplatelet therapy is standard for patients undergoing percutaneous coronary intervention (PCI) with stents. Traditionally, patients swallow the loading dose of a P2Y12 inhibitor before or during PCI. Time to achieve adequate platelet inhibition after swallowing the loading dose varies significantly. Chewed tablets may allow more rapid inhibition of platelet aggregation. However, data for this strategy in patients with stable ischemic heart disease or non-ST-elevation acute coronary syndrome (NSTE-ACS) are less robust.

Methods: In this single-center prospective trial, 112 P2Y12-naïve patients with stable ischemic heart disease or NSTE-ACS on aspirin therapy and who received ticagrelor after coronary angiography but …

Impact Of Perioperative Dexamethasone On Hospital Length Of Stay And Glycemic Control In Patients With Type 2 Diabetes Undergoing Total Hip Arthroplasty, Vanessa Williams, Mohammad J. Uddin Ansari, Amruta Jaju, Stacey Ward, Daniel O'Keefe, Jumana Abdelkarim, Nicole Montes, Ula Tarabichi, Albert Botchway, Michael G. Jakoby Iv

Journal of Patient-Centered Research and Reviews

Purpose: This study aimed to evaluate effects of perioperative dexamethasone on hospital length of stay (LOS) and glycemic control for patients with type 2 diabetes mellitus undergoing total hip arthroplasty (THA).

Methods: We performed retrospective case review of THA performed in adults (≥ 18 years old) with type 2 diabetes at Springfield Memorial Hospital (Springfield, IL) immediately before (2013), during (2014), and after (2015) publication of consensus guidelines for use of perioperative dexamethasone. Hospital LOS was the primary endpoint. Capillary blood glucose by hospital day, proportion of patients treated with insulin, and median insulin dose by hospital day …

Three-Dimensional Evaluation Of The Mandibular Lingula On Cone-Beam Computed Tomographic Images In The Turkish Population, Zerrin Unal Erzurumlu, Damla Torul

Journal of Dentistry Indonesia

Objective: The purpose of this study was to provide morphometric and anatomical data for mandibular lingula (Li) in The Turkish population using three dimensional-cone beam computed tomography (3D-CBCT) images. Methods: CBCT images of the patients taken between July 2020 and March 2021, were retrieved from the archival records. A total of 100 Li’s of 50 patients who met the criteria of this study were evaluated. The distances between the tip of the Li and ramal landmarks/occlusal plane were measured and the shape of the Li was evaluated on 3D-CBCT images. Results: CBCT images of the 50 patients (19 males and …

Therapies For Mitochondrial Disorders, Kayli Sousa Smyth, Anne Mulvihill

SURE Journal: Science Undergraduate Research Experience Journal

Mitochondria are cytoplasmic, double-membrane organelles that synthesise adenosine triphosphate (ATP). Mitochondria contain their own genome, mitochondrial DNA (mtDNA), which is maternally inherited from the oocyte. Mitochondrial proteins are encoded by either nuclear DNA (nDNA) or mtDNA, and both code for proteins forming the mitochondrial oxidative phosphorylation (OXPHOS) complexes of the respiratory chain. These complexes form a chain that allows the passage of electrons down the electron transport chain (ETC) through a proton motive force, creating ATP from adenosine diphosphate (ADP). This study aims to explore current and prospective therapies for mitochondrial disorders (MTDS). MTDS are clinical syndromes coupled with abnormalities …

Cardiac Metastasis After Curative Treatment Of Hepatocellular Carcinoma: Risk Factors, Treatment Options, And Prognosis, Gaurav Jain, Mathew Otto, Mubeen Khan Mohammed Abdul, Manpreet Chadha, Ajay Sahajpal

Journal of Patient-Centered Research and Reviews

Hepatocellular carcinoma (HCC) is primary hepatic malignancy with a high incidence of recurrence. The risk of recurrence directly correlates to patient’s overall prognosis. Management of advanced HCC involves a combination of surgical resection, locoregional therapy, and systemic treatment. Distant metastases are rare, and intraventricular cardiac metastases are even more infrequent. This brief review details an illustrative case of cardiac metastasis after curative treatment of primary HCC and then summarizes the literature on risk factors, treatment options, and patient prognosis in the setting of distant metastases from HCC. Prognosis of metastasis to the heart is generally poor, and available evidence emphasizes …

Evaluation Of Apical Debris Extrusion Of Two Full-Rotating Instruments, Hyflex Edm And Race Evo, Versus Two Reciprocating Instruments, Reciproc Blue And R-Motion: An In-Vitro Study., Carla Abi Saad, Roula Abiad

BAU Journal - Science and Technology

Complete cleaning and shaping of the root canal space is a mandatory stage for the success of root canal treatment. Extrusion of different materials apically during this step such as dentine debris, pulp tissue remnants, necrotic fragments, microorganisms and irrigants may occur. These extruded materials lead to periapical irritation, pain and/or swelling. To evaluate the apical debris extrusion of Race EVO and Hyflex EDM which are full-rotating instruments, versus R-motion and Reciproc Blue as reciprocating instruments. Forty extracted human mandibular premolar teeth were selected with single canals not affected by fluorosis, resorption, or fracture. Teeth were then randomly divided into …

Review: Conventional Thrombectomy With Intraoperative Fluoroscopy In Acute Limb Ischemia Rutherford Iib, Heru Angkoso, Dedy Pratama

The New Ropanasuri Journal of Surgery

Introduction. Acute limb ischemia (ALI) is a severe condition affecting the extremities and the patient’s survival that requires immediate treatment. It can be treated with either surgical or endovascular revascularization or both (hybrid procedure). It is crucial to evaluate the defect using intraoperative fluoroscopy or angiography in each case. The review aimed to find out the outcomes of the thrombectomy with intraoperative fluoroscopy for ALI Rutherford IIb.

Method. According to the PRISMA protocol, the literature search proceeded in online databases, i.e., Cochrane, Scopus, PubMed, and EBSCOhost, with no year limitation on the publication. All articles were screened and critically appraised. …

A Case Of Cryptomenorrhea Presenting As - Acute Abdominal Pain, Udisha Arya Ms., Ritu Mittal Arya Dr.

Digital Journal of Clinical Medicine

BACKGROUND:

The transverse vaginal septum is a congenital Mullerian abnormality caused due to improper fusion of the Müllerian ducts with urogenital sinus. It is classified as complete or incomplete and obstructive or non-obstructive and occurs at various levels such as superior vaginal (46%), mid-vaginal(40%) and inferior vaginal(14%). Transverse vaginal septum is a rare condition with incidence varying from 1:2100 to 1:72,000. The condition is difficult to manage often due to delayed diagnosis and is usually diagnosed when hematocolpos lead to symptoms due to an expanding pelvic mass

CASE DESCRIPTION:

A 14-year-old female adolescent presented with a history of acute pain …